The Effects of Advance Care Planning Interventions on Nursing Home Residents: A Systematic Review

Martin, Ruth; Hayes, Barbara; Gregorevic, Kate; Lim, Wen Kwang

doi:10.1016/j.jamda.2015.12.017

Cited by 210 publications

(193 citation statements)

References 45 publications

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“…A systematic review of 113 studies suggested that ACP interventions decreased life-sustaining treatment (LST), increased use of hospice and palliative care, prevented hospitalization, and increased compliance with patients’ end-of-life wishes [13]. Another systematic review indicated that ACP decreased hospitalization rate of nursing home residents by 9–26% and increased the number of residents dying in their nursing homes by 29–40% [14]. Moreover, ACP increased the completion of ADs, concordance between preferences for care and delivered care, and likelihood of improvement of other outcomes for patients and their loved ones [15].…”

Section: Introductionmentioning

confidence: 99%

Social workers’ involvement in advance care planning: a systematic narrative review

2017

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BackgroundAdvance care planning is a process of discussion that enables competent adults to express their wishes about end-of-life care through periods of decisional incapacity. Although a number of studies have documented social workers’ attitudes toward, knowledge about, and involvement in advance care planning, the information is fragmented. The purpose of this review was to provide a narrative synthesis of evidence on social workers’ perspectives and experiences regarding implementation of advance care planning.MethodsSix databases were searched for peer-reviewed research papers from their respective inception through December 2016. All of the resulting studies relevant to both advance care planning and social worker were examined. The findings of relevant studies were synthesized thematically.ResultsThirty-one articles met the eligibility criteria. Six research themes were identified: social workers’ attitudes toward advance care planning; social workers’ knowledge, education and training regarding advance care planning; social workers’ involvement in advance care planning; social workers’ perceptions of their roles; ethical issues relevant to advance care planning; and the effect of social work intervention on advance care planning engagement. The findings suggest that there is a consensus among social workers that advance care planning is their duty and responsibility and that social workers play an important role in promoting and implementing advance care planning through an array of activities.ConclusionsThis study provides useful knowledge for implementing advance care planning through illustrating social workers’ perspectives and experiences. Further studies are warranted to understand the complexity inherent in social workers’ involvement in advance care planning for different life-limiting illnesses or within different socio-cultural contexts.

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Section: Introductionmentioning

confidence: 99%

Social workers’ involvement in advance care planning: a systematic narrative review

2017

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“…Since most elderly people who require a discussion about their EOL care have insufficient ability to make decisions (31), ACP is important (32)(33)(34)(35)(36). In nursing home settings, it is also effective in fulfilling residents' wishes for their EOL care and avoiding undesired medical treatment (11,37); however, ACP had been not widespread among nursing homes in developed countries including Japan (11,38,39). Therefore, we speculate that assuring the framework for quality preservation, including ACP, by the bonus might contribute to increasing the number of residents receiving EOL care in nursing homes.…”

Section: Possible Reasons Related To Eol Care In Nursing Homes By Thementioning

confidence: 99%

End-of-life care bonus promoting end-of-life care in nursing homes: An 11-year retrospective longitudinal prefecture-wide study in Japan

Nishiguchi

Sugaya

Sakamaki

et al. 2017

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“…Owing to lack of high quality studies in the area, the evidence is mainly taken from pooled low-quality publications. 3 This study will perform a cluster randomised controlled trial in the area to provide the required data on medical treatment order effects in the RACF population. This trial design will allow for clustering of sites with similar key baseline characteristics thus limiting the intracluster variance and allowing for better comparison.…”

Section: Discussionmentioning

confidence: 99%

“…3 Studies in the USA have shown improvements in treatment decisions for residents with the introduction of medical treatment forms such as the Physician Orders for Life-Sustaining Treatment (POLST) and others adapted from it. 4 Such studies have not been conducted in Australia and the intention of this study is to show that such innovations are translatable to our target population.…”

Section: Introductionmentioning

confidence: 99%

Implementation of ‘Goals of Patient Care’ medical treatment orders in residential aged care facilities: protocol for a randomised controlled trial

et al. 2017

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IntroductionSystematic reviews demonstrate that advance care planning (ACP) has many positive effects for residents of aged care facilities, including decreased hospitalisation. The proposed Residential Aged Care Facility (RACF) ‘Goals of Patient Care’ (GOPC) form incorporates a resident's prior advance care plan into medical treatment orders. Where none exists, it captures residents' preferences. This documentation helps guide healthcare decisions made at times of acute clinical deterioration.Methods and analysisThis is a mixed methods study. An unblinded cluster randomised controlled trial is proposed in three pairs of RACFs. In the intervention arm, GOPC forms will be completed by a doctor incorporating advance care plans or wishes. In the control arm, residents will have usual care which may include an advance care plan. The primary hypothesis is that the GOPC form is superior to standard ACP alone and will lead to decreased hospitalisation due to clearer documentation of residents' medical treatment plans. The primary outcome will be an analysis of the effect of the GOPC medical treatment orders on emergency department attendances and hospital admissions at 6 months. Secondary outcome measurements will include change in hospitalisation rates at 3 and 12 months, length of stay and external mortality rates among others. Qualitative interviews, 12 months post GOPC implementation, will be used for process evaluation of the GOPC and to evaluate staff perceptions of the form's usefulness for improving communication and medical decision-making at a time of deterioration.DisseminationThe results will be disseminated in peer review journals and research conferences. This robust randomised controlled trial will provide high-quality data about the influence of medical treatment orders that incorporate ACP or preferences adding to the current gap in knowledge and evidence in this area.Trial registration numberACTRN12615000298516, Results.

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The Effects of Advance Care Planning Interventions on Nursing Home Residents: A Systematic Review

Cited by 210 publications

References 45 publications

Social workers’ involvement in advance care planning: a systematic narrative review

Social workers’ involvement in advance care planning: a systematic narrative review

End-of-life care bonus promoting end-of-life care in nursing homes: An 11-year retrospective longitudinal prefecture-wide study in Japan

Implementation of ‘Goals of Patient Care’ medical treatment orders in residential aged care facilities: protocol for a randomised controlled trial

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